PENSON FINANCIAL SERVICES, INC.

CUSTOMER ACCOUNT TRANSFER FORM

Receiving Firm – Penson Financial Services, Inc. (“PFSI”) – Clearing # 0158

1. Information about your account: Title of Your Account:

PFSI Account Number: SSN / Tax ID: ** Please attach a copy of your most recent statement for the account you are transferring to Penson.

2. Information about the account you are transferring: Title of Your Account:

Account Number: Name of Firm:

Address of Firm:

City, State, ZIP Broker Clearing No: ** If your PFSI account is not the same type of account as the one you are transferring, you must

complete the Letter of Authorization (Section 7) on the 2nd page of this form.

3. Type of Transfer: Brokerage Firm Transfer (Transfer all assets in kind) Non-ACAT Transfer (Transfer all assets in kind) Liquidate all assets and Transfer as cash Liquidate annuity and transfer as cash

Partial Transfer (Skip to Section 4) Liquidate Certificates of Deposit IMMEDIATELY. (I am aware of and acknowledge the penalty for early withdrawal)

Mutual Fund Company Transfer (Skip to Section 5) Transfer proceeds of Certificates of Deposit AT MATURITY (Submit transfer request 30 days prior to maturity).

4. Partial Transfer: (Please specify the assets you wish to transfer, Attach additional pages if needed) Quantity Assets Description / Symbol Transfer (Select One)

Transfer In Kind Liquidate

Transfer In Kind Liquidate

Transfer In Kind Liquidate

Transfer In Kind Liquidate

Transfer In Kind Liquidate

5. Mutual Fund Company Transfer: (Use a separate form for each mutual fund company)

Name of Fund Company:

Name of Fund/Symbol/Cusip Fund Account #

Transfer (Select One)

Future Dividend (Select One)

Future Capital Gains (Select One)

Transfer In Kind Liquidate ALL

# of Shares _____ Reinvest Pay in Cash

Reinvest Pay in Cash

Transfer In Kind Liquidate ALL

# of Shares _____ Reinvest Pay in Cash

Reinvest Pay in Cash

Transfer In Kind Liquidate ALL

# of Shares _____ Reinvest Pay in Cash

Reinvest Pay in Cash

6. Signature(s): (Please read and sign below)

If this account is a qualified retirement account, I have amended the applicable plan so that it names Penson Financial Services, Inc. (PFSI) as successor custodian. Unless otherwise indicated in the instructions above, please transfer all assets in my account to PFSI. I understand that to the extent any assets in my account are not readily transferable with or without penalties; such assets may not be transferred within the time frames required by NYSE Rule 412 or similar rule of FINRA or other designated examining authority.